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Biomedical subjects

A V Shmigel'skiĭ

Publications and source records attributed to A V Shmigel'skiĭ.

7 recordsLinked to original sources
PubMedDate not supplied

[Cerebral oximetry in neurosurgical patients with cerebrovascular diseases. I. Analysis of causes of intraoperative changes in rSO2 values and its prognostic significance].

A total of 144 neurosurgical interventions were performed in 138 patients with cerebrovascular diseases (arterial aneurysms in the acute and cold periods after a subarachnoidal hemorrhage, arteriovenous malformations, and carotid-cavernous anastomoses). Intraoperative monitoring of regional saturation of hemoglobin with oxygen in the blood flowing in brain vessels was carried out by a cerebral oximeter INVOS 3100 for early intraoperative diagnosis of cerebral ischemia. This paper analyzes factors affecting changes in rSO2 parameter during surgery and discusses the prognostic significance of the detected shifts. Various factors affected the time course of rSO2: decrease in AP within the framework of controlled arterial hypotone and other causes, insertion of autosupported retractor spatulae, temporary clipping and embolism of cerebral arteries, vasospasm, aneurysm rupture, dissection of arteriovenous malformation, etc. Any intraoperative shift of rSO2 surpassing 5%, no matter of what direction (decrease or increase), deserves special attention of anesthesiologist, as it indicates development of cerebral ischemia with a high degree of probability.

Adolescent↗
PubMedDate not supplied

[Pharmacological protection of the brain during surgery in patients with giant cerebral aneurysms].

The authors discuss the results of pharmacological protection of the brain, consisting in intraarterial or intravenous infusion of drugs (sodium thiopental, nimodipine, ketamine) during intracranial interventions in 13 patients with giant arterial aneurysms of the anterior portions of Willis' circle. In some patients drug protection of the brain prevented the development of ischemic focus in the basin of temporarily occluded vessel. Intraarterial infusion of protector drugs is preferable because it allows decreasing the doses and severity of untoward hemodynamic effects.

Adult↗
PubMedDate not supplied

[Surgical treatment of occlusive and stenosing lesions of brachiocephalic arteries].

The results of surgical treatment of patients with occlusive and stenosing lesions of brachiocephalic arteries implemented at Burdenko's Research Institute of Neurosurgery of the Russian Academy of Medical Sciences (RAMS) during 1999-2002 are described. A total of 164 operations were made in 128 patients. Different diagnostic methods and indications for various types of reconstructive and revascularization surgeries are under discussion. A variety of the carotid endarterectomy techniques and the conditions needed for their implementation (microsurgical equipment and intraoperative multi-modality neuromonitoring) are defined. Finally, the main complications and the methods of their prevention, correction and treatment are also described.

Adolescent↗
PubMedDate not supplied

[Cerebral oximeter INVOS-3100].

A new device is described: cerebral oximeter intended for monitoring cerebral oxygenation and early diagnosis of cerebral ischemia and hypoxia. The advantages and shortcomings of the proposed method are analyzed in comparison with other current methods for the early diagnosis of cerebral ischemia.

Blood Gas Monitoring, Transcutaneous↗
PubMedDate not supplied

[Use of cerebral oximetry in early diagnosis of cerebral ischemia in neurosurgical patients with cerebrovascular diseases].

Using a new device, INVOS-3100 cerebral oximeter, the rSO2 parameter (oxygen saturation of blood hemoglobin in cerebral vessels) was monitored during neurosurgical interventions in 84 patients with cerebrovascular diseases (arterial aneurysms, arteriovenous malformations, and carotid-cavernous anastomoses). Six patients developed grave ischemic complications. In five of them the cerebral oximeter showed a more than 5% reduction of the parameter in question (by 11%, on an average). The findings permit a conclusion that cerebral oximetry is an adequate method of early diagnosis of ischemia in neurosurgical patients with cerebrovascular diseases.

Adult↗
PubMedDate not supplied

[Use of Bullard laryngoscope in intubation of the trachea].

Bullard laryngoscope was for the first time used for intubation of the trachea in 232 neurosurgical patients. The advantages of the new laryngoscope and specific problems associated with its use are discussed. The principal advantage is no need in direct laryngoscopy, which permits using this instrument in patients with short and rigid neck, in those with ankylosis of the temporomandibular joint, with injuries to, or unstable spine. The problems are mainly related to obturation of the optic system of the laryngoscope by secretion and to selection of an adequate diameter of the intubation tube.

Adolescent↗